open access
Are adipokines associated with atrial fibrillation in type 2 diabetes?
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology and Hypertension, Central Clinical Hospital, the Ministry of the Interior and Administration, Warsaw, Poland
- Centre for Preclinical Research and Technology (CePT), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
- Department of Internal Diseases and Endocrinology, Medical University of Warsaw, Warsaw, Poland
open access
Abstract
Introduction: The potential effect of adipokines on the development of AF is yet to be established. The aim of this study was to investigate the association of baseline serum adipokines with 1) the presence of AF at baseline and 2) future risk of AF development.
Material and methods: The current study is a sub-analysis of the prospective, randomised AVOCADO (Aspirin Vs./Or Clopidogrel in Aspirin-resistant Diabetics inflammation Outcomes) trial. The AVOCADO study included patients with type 2 DM burdened with at least two additional cardiovascular risk factors and receiving acetylsalicylic acid. In patients included in the current analysis adipokines and inflammatory biomarker levels were measured. Information on the subsequent AF diagnosis was collected after a median of 5.4 years of follow-up.
Results: A total of 273 patients with type 2 DM (median age 68 years; 52% male) were included in the initial analysis comparing patients with and without AF at baseline. Patients with diagnosed AF (12%) had higher levels of serum resistin [8.5 (5.8–10.5) vs. 6.9 (5.6–8.7) ng/mL; p = 0.034], adiponectin [6.9 (5.6–8.7) vs. 2.7 (1.8–4.2) ng/mL; p = 0.032], and N-terminal pro-B-type natriuretic peptide [336 (148–473) vs. 108 [45–217]; p < 0.001) than non-AF patients. There were no significant differences in serum leptin, IL-6, and TNF-alpha concentrations between the two groups. From subjects without known AF at study entry, 19% developed AF at follow-up. In logistic regression analysis, baseline adipokine levels did not predict AF development.
Conclusion: In type 2 DM, patients with AF have higher resistin and adiponectin concentrations than patients with no AF. None of the studied adipokines proved a predictor of future AF development.
Abstract
Introduction: The potential effect of adipokines on the development of AF is yet to be established. The aim of this study was to investigate the association of baseline serum adipokines with 1) the presence of AF at baseline and 2) future risk of AF development.
Material and methods: The current study is a sub-analysis of the prospective, randomised AVOCADO (Aspirin Vs./Or Clopidogrel in Aspirin-resistant Diabetics inflammation Outcomes) trial. The AVOCADO study included patients with type 2 DM burdened with at least two additional cardiovascular risk factors and receiving acetylsalicylic acid. In patients included in the current analysis adipokines and inflammatory biomarker levels were measured. Information on the subsequent AF diagnosis was collected after a median of 5.4 years of follow-up.
Results: A total of 273 patients with type 2 DM (median age 68 years; 52% male) were included in the initial analysis comparing patients with and without AF at baseline. Patients with diagnosed AF (12%) had higher levels of serum resistin [8.5 (5.8–10.5) vs. 6.9 (5.6–8.7) ng/mL; p = 0.034], adiponectin [6.9 (5.6–8.7) vs. 2.7 (1.8–4.2) ng/mL; p = 0.032], and N-terminal pro-B-type natriuretic peptide [336 (148–473) vs. 108 [45–217]; p < 0.001) than non-AF patients. There were no significant differences in serum leptin, IL-6, and TNF-alpha concentrations between the two groups. From subjects without known AF at study entry, 19% developed AF at follow-up. In logistic regression analysis, baseline adipokine levels did not predict AF development.
Conclusion: In type 2 DM, patients with AF have higher resistin and adiponectin concentrations than patients with no AF. None of the studied adipokines proved a predictor of future AF development.
Keywords
atrial fibrillation; diabetes mellitus; adipokines; resistin; adiponectin; leptin
Title
Are adipokines associated with atrial fibrillation in type 2 diabetes?
Journal
Issue
Article type
Original paper
Pages
34-41
Published online
2019-11-22
Page views
2206
Article views/downloads
1078
DOI
Pubmed
Bibliographic record
Endokrynol Pol 2020;71(1):34-41.
Keywords
atrial fibrillation
diabetes mellitus
adipokines
resistin
adiponectin
leptin
Authors
Michał Peller
Agnieszka Kapłon-Cieślicka
Marek Rosiak
Agata Tymińska
Krzysztof Ozierański
Ceren Eyileten
Agnieszka Kondracka
Dagmara Mirowska-Guzel
Grzegorz Opolski
Marek Postuła
Krzysztof J. Filipiak
- Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37(38): 2893–2962.
- Kishore A, Vail A, Majid A, et al. Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis. Stroke. 2014; 45(2): 520–526.
- Henriksson KM, Farahmand B, Åsberg S, et al. Comparison of cardiovascular risk factors and survival in patients with ischemic or hemorrhagic stroke. Int J Stroke. 2012; 7(4): 276–281.
- Aksnes TA, Schmieder RE, Kjeldsen SE, et al. Impact of new-onset diabetes mellitus on development of atrial fibrillation and heart failure in high-risk hypertension (from the VALUE Trial). Am J Cardiol. 2008; 101(5): 634–638.
- Benjamin EJ, Levy D, Vaziri SM, et al. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994; 271(11): 840–844.
- Ashburner JM, Go AS, Chang Y, et al. Effect of Diabetes and Glycemic Control on Ischemic Stroke Risk in AF Patients: ATRIA Study. J Am Coll Cardiol. 2016; 67(3): 239–247.
- Sun Y, Hu D. The link between diabetes and atrial fibrillation: cause or correlation? J Cardiovasc Dis Res. 2010; 1(1): 10–11.
- Mattu HS, Randeva HS. Role of adipokines in cardiovascular disease. J Endocrinol. 2013; 216(1): T17–T36.
- Wojciechowska C, Jacheć W, Romuk E, et al. The effect of BMI, serum leptin, and adiponectin levels on prognosis in patients with non-ischaemic dilated cardiomyopathy. Endokrynol Pol. 2017; 68(1): 26–34.
- Horakova D, Stepanek L, Nagelova R, et al. Total and high-molecular-weight adiponectin levels and prediction of insulin resistance. Endokrynol Pol. 2018; 69(4): 375–380.
- Kapłon-Cieślicka A, Postuła M, Rosiak M, et al. Association of adipokines and inflammatory markers with lipid control in type 2 diabetes. Pol Arch Med Wewn. 2015; 125(6): 414–423.
- Postula M, Kaplon-Cieslicka A, Rosiak M, et al. Genetic determinants of platelet reactivity during acetylsalicylic acid therapy in diabetic patients: evaluation of 27 polymorphisms within candidate genes. J Thromb Haemost. 2011; 9(11): 2291–2301.
- Ermakov S, Azarbal F, Stefanick ML, et al. The associations of leptin, adiponectin and resistin with incident atrial fibrillation in women. Heart. 2016; 102(17): 1354–1362.
- Rienstra M, Sun JX, Lubitz SA, et al. Plasma resistin, adiponectin, and risk of incident atrial fibrillation: the Framingham Offspring Study. Am Heart J. 2012; 163(1): 119–124.e1.
- Gharibeh MY, Al Tawallbeh GM, Abboud MM, et al. Correlation of plasma resistin with obesity and insulin resistance in type 2 diabetic patients. Diabetes Metab. 2010; 36(6 Pt 1): 443–449.
- Kim M, Oh JK, Sakata S, et al. Role of resistin in cardiac contractility and hypertrophy. J Mol Cell Cardiol. 2008; 45(2): 270–280.
- Kapłon-Cieślicka A, Tymińska A, Rosiak M, et al. Resistin is a prognostic factor for death in type 2 diabetes. Diabetes Metab Res Rev. 2019; 35(2): e3098.
- Lieb W, Sullivan LM, Harris TB, et al. Plasma leptin levels and incidence of heart failure, cardiovascular disease, and total mortality in elderly individuals. Diabetes Care. 2009; 32(4): 612–616.
- Martínez-Martínez E, Jurado-López R, Valero-Muñoz M, et al. Leptin induces cardiac fibrosis through galectin-3, mTOR and oxidative stress: potential role in obesity. J Hypertens. 2014; 32(5): 1104–1114.
- Macheret F, Bartz TM, Djousse L, et al. Higher circulating adiponectin levels are associated with increased risk of atrial fibrillation in older adults. Heart. 2015; 101(17): 1368–1374.
- Karmazyn M, Purdham DM, Rajapurohitam V, et al. Signalling mechanisms underlying the metabolic and other effects of adipokines on the heart. Cardiovasc Res. 2008; 79(2): 279–286.
- Kizer JR. Adiponectin, cardiovascular disease, and mortality: parsing the dual prognostic implications of a complex adipokine. Metabolism. 2014; 63(9): 1079–1083.
- Menzaghi C, Trischitta V. The Adiponectin Paradox for All-Cause and Cardiovascular Mortality. Diabetes. 2018; 67(1): 12–22.
- Schnabel RB, Sullivan LM, Levy D, et al. Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study. Lancet. 2009; 373(9665): 739–745.
- Parashar S, Kella D, Reid KJ, et al. New-onset atrial fibrillation after acute myocardial infarction and its relation to admission biomarkers (from the TRIUMPH registry). Am J Cardiol. 2013; 112(9): 1390–1395.
- Özcan KS, Güngör B, Altay S, et al. Increased level of resistin predicts development of atrial fibrillation. J Cardiol. 2014; 63(4): 308–312.
- Shimano M, Shibata R, Tsuji Y, et al. Circulating adiponectin levels in patients with atrial fibrillation. Circ J. 2008; 72(7): 1120–1124.
- Kim TH, Lee JS, Uhm JS, et al. High circulating adiponectin level is associated with poor clinical outcome after catheter ablation for paroxysmal atrial fibrillation. Europace. 2018; 20(8): 1287–1293.
- Marcus GM, Whooley MA, Glidden DV, et al. Interleukin-6 and atrial fibrillation in patients with coronary artery disease: data from the Heart and Soul Study. Am Heart J. 2008; 155(2): 303–309.
- Deng H, Xue Ym, Zhan Xz, et al. Role of tumor necrosis factor-alpha in the pathogenesis of atrial fibrillation. Chin Med J (Engl). 2011; 124(13): 1976–1982.
- Liew R, Khairunnisa K, Gu Y, et al. Role of tumor necrosis factor-α in the pathogenesis of atrial fibrosis and development of an arrhythmogenic substrate. Circ J. 2013; 77(5): 1171–1179.
- Fuster V, Rydén LE, Cannom DS, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines, European Society of Cardiology Committee for Practice Guidelines, European Heart Rhythm Association, Heart Rhythm Society. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006; 114(7): e257–e354.
- Nichols GA, Reinier K, Chugh SS. Independent contribution of diabetes to increased prevalence and incidence of atrial fibrillation. Diabetes Care. 2009; 32(10): 1851–1856.